The Role of Remdesivir in South Africa: Preventing COVID-19 Deaths Through Increasing Intensive Care Unit Capacity

Nichols, Brooke E; Jamieson, Lise; Zhang, Sabrina R C; Rao, Gabriella A; Silal, Sheetal P; Pulliam, Juliet; Sanne, Ian; Meyer‐Rath, Gesine

doi:10.1093/cid/ciaa937

Cited by 13 publications

(4 citation statements)

References 4 publications

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“…With remdesivir, 36,383-47,820 patients at the first peak at the end of December were treated in ICU. The study reported that the use of remdesivir in COVID-19 patients could save many lives and may also provide potential ICU bed turnover by reducing the length of ICU stay [26].…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Remdesivir Treatment in COVID-19 Patients Requiring Low-Flow Oxygen Therapy: Payer Perspective in Turkey

et al. 2021

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Introduction This study aims to evaluate the cost-effectiveness of remdesivir compared to other existing therapies (SoC) in Turkey to treat COVID-19 patients hospitalized with < 94% saturation and low-flow oxygen therapy (LFOT) requirement. Methods We compared remdesivir as the treatment for COVID-19 with the treatments in the Turkish treatment guidelines. Analyses were performed using data from 78 hospitalized COVID-19 patients with SpO 2 < 94% who received LFOT in a tertiary healthcare facility. COVID-19 episode costs were calculated for 78 patients considering the cost of modeled remdesivir treatment in the same group from the payer’s perspective. The incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) was calculated for remdesivir versus the SoC for the population identified. For Turkey, a reimbursement threshold value between USD 8599 (1 × per capita gross domestic product—GDP) and USD 25.797 (3 × GDP) per QALY was used. Results In the remdesivir arm, the length of hospital stay (LOS) was 3 days shorter than the SOC. The low ventilator requirement in the remdesivir arm was one factor that decreased the QALY disutility value. In patients who were transferred to intensive care unit (ICU) from the ward, the mean LOS was 17.3 days (SD 13.6), and the mean cost of stay was USD 155.3/day (SD 168.0), while in patients who were admitted to ICU at baseline, the mean LOS was 13.1 days (SD 13.7), and the mean cost of stay was USD 207.9/day (SD 133.6). The mean cost of episode per patient was USD 3461.1 (SD 2259.8) in the remdesivir arm and USD 3538.9 (SD 3296.0) in the SOC arm. Incremental QALYs were estimated at 0.174. Remdesivir treatment was determined to be cost saving vs. SoC. Conclusions Remdesivir, which results in shorter LOS and lower rates of intubation requirements in ICU patients than existing therapies, is associated with higher QALYs and lower costs, dominating SoC in patients with SpO 2 < 94% who require oxygen support. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01874-9.

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Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Remdesivir Treatment in COVID-19 Patients Requiring Low-Flow Oxygen Therapy: Payer Perspective in Turkey

et al. 2021

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“…Although the direct quantification of the impact of hospitalizations due to COVID-19 on lost productivity costs and absenteeism is not yet available, the impact of COVID-19 on the global economic and financial markets has been significant, with reductions in income and a rise in unemployment [ 31 ]. Furthermore, RDV reduces the number of days in hospital and thus increases the capacity in the ICU by freeing up bed space [ 32 , 33 ]. Not only does this allow patients to return to work faster following discharge from hospital, but this may also aid in offsetting losses in revenue due to reduced elective surgeries [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Remdesivir for Hospitalized COVID-19 Patients in the United States: Optimization of Health Care Resources

Barnieh¹,

Beckerman²,

Jeyakumar³

et al. 2023

Infect Dis Ther

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Introduction In addition to significant morbidity and mortality, the coronavirus disease (COVID-19) has strained health care systems globally. This study investigated the cost-effectiveness of remdesivir + standard of care (SOC) for hospitalized COVID-19 patients in the USA. Methods This cost-effectiveness analysis considered direct and indirect costs of remdesivir + SOC versus SOC alone among hospitalized COVID-19 patients in the US. Patients entered the model stratified according to their baseline ordinal score. At day 15, patients could transition to another health state, and on day 29, they were assumed to have either died or been discharged. Patients were then followed over a 1-year time horizon, where they could transition to death or be rehospitalized. Results Treatment with remdesivir + SOC avoided, per patient, a total of 4 hospitalization days: two general ward days and a day for both the intensive care unit and the intensive care unit plus invasive mechanical ventilation compared to SOC alone. Treatment with remdesivir + SOC presented net cost savings due to lower hospitalization and lost productivity costs compared to SOC alone. In increased and decreased hospital capacity scenarios, remdesivir + SOC resulted in more beds and ventilators being available versus SOC alone. Conclusions Remdesivir + SOC alone represents a cost-effective treatment for hospitalized patients with COVID-19. This analysis can aid in future decisions on the allocation of healthcare resources. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-023-00816-y.

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“…A further cost-consequence study from the perspective of the US [ 54 ] and a cost-effectiveness study from Turkey [ 55 ] have reported that remdesivir would be a cost-effective and strongly dominant treatment for COVID-19, respectively. In addition, epidemiological modelling studies from Germany [ 56 ], South Africa [ 57 ], Saudi Arabia [ 58 ] and Portugal [ 59 ] have reported that remdesivir administration would result in significant increases in hospital bed capacities, while a cohort study in Hong Kong has found that early remdesivir treatment is associated with significantly shorter hospital LOS [ 60 ]. Of note, several of these studies reported reduced ICU LOS or increased ICU bed capacity with remdesivir, in line with Béraud 2020 and Soriano 2021, a notable outcome considering the substantially higher costs associated with ICU stays in comparison with general ward stays [ 32 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Remdesivir-related cost-effectiveness and cost and resource use evidence in COVID-19: a systematic review

et al. 2022

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Background The coronavirus disease 2019 (COVID-19) pandemic has been a global health emergency since December 2019, leading to millions of deaths worldwide and placing significant pressures, including economic burden, on individual patients and healthcare systems. As of February 2022, remdesivir is the only US Food and Drug Administration (FDA)-approved treatment for severe COVID-19. This systematic literature review (SLR) aimed to summarise economic evaluations, and cost and resource use (CRU) evidence related to remdesivir during the COVID-19 pandemic. Methods Searches of MEDLINE, Embase the International Health Technology Assessment (HTA) database, reference lists, congresses and grey literature were performed in May 2021. Articles were reviewed for relevance against pre-specified criteria by two independent reviewers and study quality was assessed using published checklists. Results Eight studies reported resource use and five reported costs related to remdesivir. Over time, the prescription rate of remdesivir increased and time from disease onset to remdesivir initiation decreased. Remdesivir was associated with a 6% to 21.3% decrease in bed occupancy. Cost estimates for remdesivir ranged widely, from $10 to $780 for a 10-day course. In three out of four included economic evaluations, remdesivir treatment scenarios were cost-effective, ranging from ~ 8 to ~ 23% of the willingness-to-pay threshold for the respective country. Conclusions Economic evidence relating to remdesivir should be interpreted with consideration of the broader clinical context, including patients’ characteristics and the timing of its administration. Nonetheless, remdesivir remains an important option for physicians in aiming to provide optimal care and relieve pressure on healthcare systems through shifting phases of the pandemic.

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The Role of Remdesivir in South Africa: Preventing COVID-19 Deaths Through Increasing Intensive Care Unit Capacity

Cited by 13 publications

References 4 publications

Cost-Effectiveness Analysis of Remdesivir Treatment in COVID-19 Patients Requiring Low-Flow Oxygen Therapy: Payer Perspective in Turkey

Cost-Effectiveness Analysis of Remdesivir Treatment in COVID-19 Patients Requiring Low-Flow Oxygen Therapy: Payer Perspective in Turkey

Remdesivir for Hospitalized COVID-19 Patients in the United States: Optimization of Health Care Resources

Remdesivir-related cost-effectiveness and cost and resource use evidence in COVID-19: a systematic review

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